Sudden infant death syndrome (SIDS) is one of the most mysterious disorders in medicine. While the pathophysiologic mechanisms of SIDS are not fully understood, many key environmental risk factors for SIDS are known. The most important discovery has been that the prone sleep position triples the risk for SIDS. This discovery led to the national Back to Sleep campaign in 1994 and, a dramatic, 58% decrease in SIDS incidence. Because SIDS commonly occurs in apparently healthy infants, effective interventions for SIDS will have impact on all 4.1 million infants born in the U.S. each year.
Although the Back to Sleep campaign had tremendous initial success, SIDS is still the leading cause of infant death beyond the first month of life, and its incidence has not changed since 2000. Scientific and public health communities now face two critical barriers: (1) the roles of environmental risk factors in mechanisms leading to SIDS remain unclear (i.e., why does Back To Sleep work?); and (2) despite substantial resources devoted to educating the public, >30% of U.S. infants (1.2 million) do not sleep in the recommended supine position.
Apnea monitors have been used in infants for over 30 years. However, these monitors of cardiorespiratory parameters have not prevented SIDS because they target the wrong parameters. Furthermore, changes in physiologic parameters are hard to recognize by parents and often occur too late for intervention. These monitors focused on only the physiologic parameters of the infant but not the important environmental risk factors and how the infant responds to the environmental changes. Thus, SIDS research and prevention has encountered major obstacles and SIDS remains the leading cause of death for infants over 1 month of age.